Opere Erken Evre Akciğer Kanseri Hastalarında Prognostik Faktörler Retrospektif Tek Merkez Sonuçları

Yıl 2020, , 376 - 382, 20.12.2020

Özkan Alan , Özlem Ercelep Tugba Akin Eda Tanrıkulu Rahib Hasanov Tugba Basoğlu Mehmet Akif Öztürk , Serap Kaya Nalan Akgül Tunç Laçin Emine Bozkurtlar Faysal Dane Perran Yumuk

https://doi.org/10.37696/nkmj.715690

Öz

Amaç: Küçük hücreli dışı akciğer kanseri (KHDAK) tüm akciğer kanserlerinin %85’ini oluşturmaktadır. Erken evrede küratif tedavi cerrahi olmasına rağmen nüks sık görülmektedir. Bu çalışmada merkezimizde opere olan erken evre KHDAK tanılı hastaların sonuçlarını ve prognoza etkili faktörleri retrospektif olarak değerlendirdik.

Yöntem: 2006-2018 yılları arasında kliniğimize başvuran 166 opere erken evre KHDAK hastasının dosyası retrospektif olarak değerlendirildi. Bulgular SPSS kullanılarak analiz edildi. Histopatolojik ve klinik özelliklerin için prognostik önemi araştırıldı.

Bulgular: Hastalarımızın %84’ü erkekti. Medyan tanı yaşı 61 (39-82)’di. En sık görülen patolojik alt tip adenokarsinomdu. Medyan hastalıksız sağkalım (HSK) ve genel sağkalım (GSK) 76 ay (%95CI:32.1-110.0) ve 87 ay (95%CI:59.8-114.1)’dı. Çok değişkenli analizde vaskuler invazyon varlığı daha kötü HSK ve GSK için bağımsız prognostik faktördü (HR: 2,5 ve 2.3). Adenokarsinom solid patern ise sadece daha kötü hastalıksız sağ kalım ile ilişkiliydi (HR:1.7).

Sonuç: Çalışmamıza göre vaskuler invazyon varlığının ve solid tip adenokarsinomun kötü sağ kalım ile ilişkli olduğunu gösterdik.

Anahtar Kelimeler

Küçük hücreli dışı akciğer kanseri, vasküler invazyon, solid tip adenokarsinom, prognoz, sağkalım

Kaynakça

• 1) Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin 2020; 70:7.
• 2) Alberg AJ, Samet JM. Epidemiology of lung cancer. Chest 2003; 123:21S
• 3) Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years' observations on male British doctors. BMJ 2004; 328:1519.
• 4) Raaschou-Nielsen O, Andersen ZJ, Beelen R, et al. Air pollution and lung cancer incidence in 17 European cohorts: prospective analyses from the European Study of Cohorts for Air Pollution Effects (ESCAPE). Lancet Oncol 2013; 14:813.
• 5) Lorigan P, Radford J, Howell A, Thatcher N. Lung cancer after treatment for Hodgkin's lymphoma: a systematic review. Lancet Oncol 2005; 6:773. 6) Huang YJ, Huang TW, Lin FH, et al. Radiation Therapy for Invasive Breast Cancer Increases the Risk of Second Primary Lung Cancer: A Nationwide Population-Based Cohort Analysis. J Thorac Oncol 2017; 12:782.
• 7) National Lung Screening Trial Research Team, Aberle DR, Adams AM, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 2011; 365:395.
• 8) Humphrey LL, Deffebach M, Pappas M, et al. Screening for lung cancer with low-dose computed tomography: a systematic review to update the US Preventive services task force recommendation. Ann Intern Med 2013; 159:411.
• 9) Didkowska J, Wojciechowska U, Mańczuk M, Łobaszewski J. Lung cancer epidemiology: contemporary and future challenges worldwide. Ann Transl Med. 2016;4(8):150. doi:10.21037/atm.2016.03.11
• 10) Goldstraw P, Crowley J, Chansky K, et al. The IASLC Lung Cancer Staging Project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM Classification of malignant tumours [published correction appears in J Thorac Oncol. 2007 Oct;2(10):985]. J Thorac Oncol. 2007;2(8):706–714. doi:10.1097/JTO.0b013e31812f3c1a
• 11) Battafarano RJ, Piccirillo JF, Meyers BF, et al. Impact of comorbidity on survival after surgical resection in patients with stage I non-small cell lung cancer. J Thorac Cardiovasc Surg 2002; 123:280.
• 12) Yi E, Bae MK, Cho S, Chung JH, Jheon S, Kim K. Pathological prognostic factors of recurrence in early stage lung adenocarcinoma. ANZ J Surg. 2018;88(4):327–331. doi:10.1111/ans.14033
• 13) Varlotto JM, Recht A, Nikolov M, Flickinger JC, Decamp MM. Extent of lymphadenectomy and outcome for patients with stage I nonsmall cell lung cancer. Cancer. 2009;115(4):851–858. doi:10.1002/cncr.23985
• 14) Hsu CP, Hsia JY, Chang GC, et al. Surgical-pathologic factors affect long-term outcomes in stage IB (pT2 N0 M0) non-small cell lung cancer: a heterogeneous disease. J Thorac Cardiovasc Surg. 2009;138(2):426–433. doi:10.1016/j.jtcvs.2008.12.035
• 15) Devesa SS, Bray F, Vizcaino AP, Parkin DM. International lung cancer trends by histologic type: male:female differences diminishing and adenocarcinoma rates rising. Int J Cancer. 2005;117(2):294–299. doi:10.1002/ijc.21183
• 16) Yousem SA, Beasley MB. Bronchioloalveolar carcinoma: a review of current concepts and evolving issues. Arch Pathol Lab Med. 2007;131(7):1027–1032. doi:10.1043/1543-2165(2007)131[1027:BCAROC]2.0.CO;2
• 17) Travis WD, Brambilla E, Nicholson AG, et al. The 2015 World Health Organization Classification of Lung Tumors: Impact of Genetic, Clinical and Radiologic Advances Since the 2004 Classification. J Thorac Oncol 2015; 10:1243.
• 18) Yoshizawa A, Motoi N, Riely GJ, et al. Impact of proposed IASLC/ATS/ERS classification of lung adenocarcinoma: prognostic subgroups and implications for further revision of staging based on analysis of 514 stage I cases. Mod Pathol 2011;24:653-64.
• 19) Hung JJ, Jeng WJ, Chou TY, et al. Prognostic value of the new International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society lung adenocarcinoma classification on death and recurrence in completely resected stage I lung adenocarcinoma. Ann Surg 2013;258:1079-86.
• 20) Nitadori J, Bograd AJ, Kadota K, et al. Impact of micropapillary histologic subtype in selecting limited resection vs lobectomy for lung adenocarcinoma of 2cm or smaller. J Natl Cancer Inst 2013;105:1212-11)
• 21) Song Z, Zhu H, Guo Z, et al. Prognostic value of the IASLC/ATS/ERS classification in stage I lung adenocarcinoma patients--based on a hospital study in China. Eur J Surg Oncol 2013;39:1262-8.
• 22) Tsuta K, Kawago M, Inoue E, et al. The utility of the proposed IASLC/ATS/ERS lung adenocarcinoma subtypes for disease prognosis and correlation of driver gene alterations. Lung Cancer 2013;81:371-6.
• 23) Sayar A, Turna A, Solak O, Kiliçgün A, Urer N, Gürses A. Nonanatomic prognostic factors in resected nonsmall cell lung carcinoma: the importance of perineural invasion as a new prognostic marker. Ann Thorac Surg. 2004;77(2):421–425. doi:10.1016/S0003-4975(03)01645-X
• 24) Shoji F, Haro A, Yoshida T, et al. Prognostic significance of intratumoral blood vessel invasion in pathologic stage IA non-small cell lung cancer. Ann Thorac Surg. 2010;89(3):864–869. doi:10.1016/j.athoracsur.2009.09.047
• 25) Macchiarini P, Fontanini G, Harbin MJ, et al. Blood vessel invasion by tumor cells predicts recurrence in completely resected T1N0Mo non-small-cell lung cancer. J Thorac Cardiovasc Surg 1993;106:80–9.
• 26) Al-Alao BS, Gately K, Nicholson S, McGovern E, Young VK, O'Byrne KJ. Prognostic impact of vascular and lymphovascular invasion in early lung cancer. Asian Cardiovasc Thorac Ann. 2014;22(1):55–64. doi:10.1177/0218492313478431